Change of details for Club Officer

(This form will submit the information to the District Secretary who will inform District Governor, other District Officers and Clubs, as necessary)

Please ensure all items marked with * are completed
.

*Club Name

*Members Name

*Club Office

*Your Email address

New details - Fill in as appropriate
.

Address Line1

Address Line2

Address Line3

Address Line4

Postcode

Tel Pri

Tel Bus

Fax

Email

Message if any

Please check details before submitting

A copy of the results from this form that you have submitted, will be automatically sent to the email address you have supplied in " Your email address" as confirmation